title: Medical students' and residents' conceptual structure of empathy: a qualitative study.
abstract: BACKGROUND
  Empathy is a crucial component of medicine. However, many studies that have used quantitative methods have revealed decline of learners' empathy during undergraduate and postgraduate medical education. We identified medical students' and residents' conceptual structures of empathy in medicine to examine possible differences between the groups in how they conceive empathy.
  
  
  METHODS
  We conducted a qualitative study with two focus group discussions in which six medical students and seven residents participated separately. The transcripts of the focus group discussions were analysed combining qualitative data analysis and theoretical coding.
  
  
  RESULTS
  Medical students and residents had different conceptual structures of empathy. While medical students thought that sharing emotions with patients was essential to showing empathy, residents expressed empathy according to their evaluation of patients' physical and mental health status. If the residents thought that showing empathy was necessary for the care of patients, they could show it, regardless of whether they shared the patients' emotions or not.
  
  
  CONCLUSIONS
  The comparison of medical students' and residents' conceptual structures of empathy reveals a qualitative difference. Residents show more empathy to their patients by a cognitive decision as clinicians than medical students do. Communication skills training should consider the qualitative change of students' and residents' empathy with clinical experience. We should consider the change when we evaluate learners' empathy and introduce methods that cover the qualitative range of empathy.
authors.affiliation: Department of General Medicine, Faculty of Medicine, Graduate School of Education and Human Development, Nagoya, Japan. maomatsu@med.nagoya-u.ac.jp
authors.forename: Muneyoshi
authors.initials: M
authors.lastname: Aomatsu
authors.forename: Takashi
authors.initials: T
authors.lastname: Otani
authors.forename: Ai
authors.initials: A
authors.lastname: Tanaka
authors.forename: Nobutaro
authors.initials: N
authors.lastname: Ban
authors.forename: Jan
authors.initials: J
authors.lastname: van Dalen
mesh_terms: D000328:Adult; D004645:Empathy; D005260:Female; D017144:Focus Groups; D006304:Health Status; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008603:Mental Health; D010817:Physician-Patient Relations; D013337:Students, Medical / Q000523:psychology*; D055815:Young Adult